From
StayCurrentMD
Disruptive technologies in medical education: escape rooms, virtual reality, and gamification
With Dr. M Tom Bash & Dr. Rami Chapin
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Medical education has changed focus to a more learner-centered model, placing learners at the center of innovation in training over the past two decades.
Escape room exercises help healthcare teams develop and enhance communication, teamwork, and resilience skills, as well as reinforce medical knowledge.
When used effectively, escape rooms act as a low-cost high effect resource for a variety of learners.
Texas Children's Hospital The Woodlands, University of Kansas Health System, Penn Presbyterian Medical Center, and University of Minnesota have built medical escape rooms to improve education among trainees.
Virtual reality is a simulated 3D environment that allows users to explore and interact with virtual surroundings in a way that looks like reality.
Thumbay Group from Dubai, UAE is the first to build a virtual hospital on a metaverse to interact with patients and improve patient experience.
The virtual hospital provides patients with immersive healthcare experience from patient experience center to complete hospital walkthrough and services, allowing consultation via virtual headsets.
VR can be used to ease anxiety before procedures or during imaging, help pain post-operatively, and in some cases reduce the need for sedation or general anesthesia during minor surgical procedures.
The Childhood Anxiety Reduction through Innovation and Technology program (Chariot) at Stanford aims to take existing technologies and create new ones to address unique needs of individual patients.
Gamification is the application of typical elements of game playing to other areas of activities, especially tasks that are not enjoyable, to encourage engagement with a product or service.
Precision OS creates surgical simulations to accelerate skill acquisition and surgical readiness, with VR learning partnerships at 29 medical institutions in North America including University of Connecticut, University of Toronto, and University of British Columbia.
Surgeons used VR to separate twins with conjoined heads in a 27-hour long surgery, spending hours training using VR projection with Precision OS Envision while wearing an Oculus VR headset.
Patient wristbands, especially for young patients like children and babies, can create problems: they are difficult to fasten, may irritate the skin, must be rotated to be scanned, can be too tight causing pain or too loose causing loss.
Identity Shield is a smart ID sticker to replace hospital wristbands, RFID enabled with an optical scanning option.
RFID stands for radio frequency identification and uses electromagnetic fields to automatically identify and track tags attached to objects.
Northwell Health, New York state's largest healthcare system, used the Identity Shield badge on over 30,000 patients between October 2019 and November 2020, mostly at Lenox Health Hospital in New York City during the pandemic.
NFC stands for near field communications, a set of communication protocols enabling communication between two electronic devices, with interaction limited to an extremely short range of 4 centimeters or an inch and a half or less.
Escape rooms are time-bound immersive adventure experiences with hidden clues and keys, where participants try to get out before time ends, typically including sequential puzzles or escape box challenges.
Medical escape rooms have been utilized to teach and reinforce topics including discussing cancer diagnosis, cardiovascular physiology, and fluids and electrolytes.
Institutions are adopting medical escape rooms to teach residents, nursing staff, and other trainees to recognize and respond to medical conditions like preeclampsia, sepsis, and patient safety.
Casey Davis and colleagues published a how-to guide for building medical escape rooms in Medical Teacher journal in April 2022.
Metaverse is an integrated network of 3D virtual worlds accessed with VR headsets, with users navigating using eye movements, feedback controllers, and voice commands.
Avatars can visit multiple doctors in virtual clinics or get second opinions from various healthcare professionals in the virtual hospital.
Virtual hospitals offer first aid and preventative health programs using AR, VR, and artificial intelligence software to educate patients and suggest treatment plans.
In 2018, Lucille Packard Children's Hospital Stanford piloted VR capabilities in pediatric clinical settings and expanded its VR program to over 150 use cases per month, helping young patients beyond the hospital.
Stanford Medicine Children's Health is home to one of the nation's largest VR programs.
A team of physicians, engineers, researchers, and child life professionals is piloting virtual reality experiences, new tablet-based apps, and interactive bedside projector-based games at Stanford.
A prospective randomized controlled trial from Seoul National University College of Medicine showed VR experience of the preoperative process could reduce preoperative anxiety and improve compliance during anesthetic induction in children undergoing elective surgery and general anesthesia.
Induu allows healthcare professionals to create a unique digital copy of their patient using CT or MRI scans, which surgeons can review with a virtual headset before going into the case.
The National Institute of Health, OSF Healthcare, and Children's Hospital of Illinois use Induu for training surgical teams, evaluating patient cases, research collaborations, and more.
A significant percentage of surgical residents report they do not feel ready to independently perform procedures upon completion of their training.
VR training represents an accessible, cost-effective, and deliberate practice methodology to help surgeons reach a competency threshold or achieve surgical mastery.
The FDA approved Precision OS Envision as a VR preoperative planning tool, with the patented software available in early 2022, letting surgeons use an Oculus Quest 2 device for preoperative planning.
The surgery's direction was from Great Ormond Street Hospital in London while the actual surgery was happening in Rio de Janeiro.
Proximy allows multiple people in remote locations to virtually interact in a way which mimics what they would experience if collaborating in the same operating room, using artificial intelligence, machine learning, and augmented reality.
Clinicians using Proximy can remotely interact in a live procedure or assessment from start to finish, physically showing each other where to make an incision in real time or using physical gestures to illustrate a technique.
The Identity Shield sticker is made of very thin plastic material that is adhesive, non-reactive, and hypoallergenic, includes PHI like first and last name, date of birth, blood type, or possible allergies, and lasts for 7 days on patients.
Common use of Identity Shield is in NICU, newborns, and children due to the high loss rate of wristbands, which is 12% in these populations.
According to the pilot study, patient, nurse, and clinical staff feedback was overwhelmingly positive at 80% of clinicians preferring the Identity Shield over traditional wristbands.
With the RFID layer, hospital staff can use NFC to read the Identity Shield badge without ever having to lift the patient's sleeve.
NFC has been a staple feature on smartphones for several years: the first Android device included NFC in 2010, and Apple followed in 2014, meaning NFC has been present since iPhone 6.
Children's Health in Dallas, Texas is now using Identity Shield after Northwell Health.